1. The Field of the Invention
The present invention is directed generally to surgical aid devices, and more particularly, to a patient positioner for maintaining a patient's position while placed atop an operating table in the Trendelenburg, supine, left or right tilt and lithotomy positions.
2. Background Art
Briefly, there are many devices and methods known in the art for maintaining a patient's position on an operating table during an operation. After the patient is positioned on an operating table, the tilt angle and height of the operating table is generally adjusted to facilitate the operating crew's access to a surgical site or to gravitationally move organs out of the way such as in the case of a laparoscopy procedure. When the operating table is tilted in the lengthwise or widthwise direction, the operating crew runs the risk of causing the patient to slide longitudinally, roll laterally or otherwise undesirably change his/her position. A corrective action is then required to move the patient to a position or orientation favorable for access. Such action can be tedious, time-consuming and especially hazardous if the surgical operation is well in progress.
It is a common practice to position a pair of cushioned pads in abutment with the shoulders to prevent the patient from sliding toward the head end of the operating table when the patient is laid flat on the back with the feet higher than the head (known as the Trendelenburg position). In some cases, additional devices are used in conjunction with the shoulder cushion pads to aid in securing a patient in the Trendelenburg position. U.S. Pat. No. 6,622,324 discloses the use of padded hip braces to support a patient by the hip in conjunction with a pair of shoulder pads in the Trendelenburg position where a brace is disposed on each side of the waist, above the hips. The padding provided on such devices is generally minimal compared to the weight exerted on them, thereby causing significant pressure to develop in the patient's body parts that come in contact with the pads. For instance, prolonged contact of a patient's shoulders and waist with the pads in the Trendelenburg position can significantly increase the likelihood of the patient developing bruising or nerve damage due to pressure points in the shoulders and waist.
It is also a common practice to use a second combination of apparatus to maintain a patient in the Trendelenburg position. A generally rectangular draw sheet is first disposed atop an operating table, substantially in alignment with the lengthwise and widthwise direction of the operating table. A patient is then positioned atop the draw sheet and a foam pad is placed under each arm to cradle the arm. The draw sheet is then drawn taut, making sure that there is sufficient sheet area adjacent to the arms such that each lateral side of the sheet can be brought from under a padded arm around and over the padded arm and eventually tucked under the patient's torso. While not secured to the operating table or other structure, the draw sheet used in this manner is believed to provide additional restraining value of the patient to the operating table and protection to the arms. However, the draw sheet is not specifically configured for such an application and lends itself to improper usage. Often times, wrinkles are formed with an improperly sized or positioned draw sheet. When a draw sheet is tucked under a patient's torso, pressure points can develop on the back and in parts of the arms especially near a joint area such as the armpit or the elbow. A foam pad is then placed over the patient's chest before two large belts are placed criss-cross over the foam pad, such that their ends are secured to the side rails of the operating table in an attempt to compress the foam pad and secure the patient to the operating table.
There are several drawbacks associated with using belt tension alone to secure a patient by the chest and tucking the side edges of a draw sheet over the arms and under the patient's torso in an attempt to maintain the patient in the Trendelenburg position. Conventional wisdom teaches that in order to prevent downward sliding of a patient with tension exerted at right angle to the direction of slide, one must apply a significant amount of tension in the belts to create sufficient friction between the belts and the foam pad and hence the patient. However, applying a large amount of pressure on the chest can cause pressure points to develop in the chest, and in certain cases, this causes difficulty in breathing. Failing to apply sufficient tension in the belts results in insufficient friction to retain the patient in the Trendelenburg position.
U.S. Pat. Pub. No. 20090090370 discloses a patient restraint system for preventing a patient's shoulders from rising or “shrugging” during a medical procedure. The patient lies on a table and wears a jacket. A number of straps are used to couple the jacket to the table. Each strap has a first end and a second end. The first end of each strap is coupled to the jacket and the second end of each strap is coupled to the table. The straps have sufficient tension to prevent the patient's shoulders from rising or “shrugging” during the medical procedure. The patient's feet rest on a foot plate to prevent the patient from sliding toward the foot of the table due to the force exerted on the patient's shoulders because of the tension of the straps. Even though the foregoing disclosure provides a system capable of being used to restrain a patient, it is not suitable for use with a surgical procedure which requires abdominal and lower body access for the surgical crew.
In view of the foregoing drawing drawbacks, there exists a need for a safe and effective operating table patient positioner capable of maintaining a patient's position with respect to the operating table, which once deployed, allows unobstructed access to the patient's abdominal and lower body while the patient is positioned in the Trendelenburg, supine, left or right tilt or lithotomy positions.